Vitamin B12 Deficiency In Type 2 Diabetes Patients Receiving Long-Term Metformin Therapy: Experience From The Royal Jordanian Medical Services

Abstract

Background: Type 2 diabetes mellitus (T2DM) is an important chronic disease area with global dissemination. For the reason that metformin is the first drug in the management of T2DM, the use of metformin in the management of T2DM is being scrutinized. Long-term use of the drug has been associated with a deficiency of vitamin B12, the deficiency being related to the diabetes complex of anemia and nerve disorder body complications. Objective: To evaluate the deficiency of B12 vitamin in patients with Type 2 diabetes who are undergoing treatment with metformin within the Royal Jordanian Medical Services. Specific attention is placed on determining the clinical and demographic characteristics of an individual, the B12 vitamin deficiency, studying metformin dosage, and the duration of therapy. Methods:  Serum vitamin B12 levels were obtained, and cross-sectional studies were performed along the Mylan region, including the 500 patients located in the capital vicinity of Al-Madinah Medical complex. Clinical B12 deficiency was diagnosed with B12 levels in serum falling below 200pg/mL. Statistical B12 deficiency, along with associated clinical variables, was used for hypothesis testing. Results: Positive deficiency B12 levels were 128 out of the 500, making the B12 deficiency prevalence 25.6%. Diabetes duration and metformin duration associated with a calcium deficiency were found to be important. Also, Vitamin B12 deficiency was prominent when metformin was increased. Other variables found with low results were age and gender. Conclusion: Vitamin B12 deficiency is prevalent among T2DM patients on prolonged metformin therapy; prolonged treatment duration and greater cumulative dose increase the odds of deficiency. Potentially irreversible complications will only be partially mitigated through routine monitoring. These complications emphasize the importance of protocolized routine management of tertiary care to outcome-oriented temporary management of patients.